Association Between Ankylosing Spondylitis and Periodontitis: A Systematic Review

Area of Science:

• Rheumatology
• Periodontology
• Immunology

Background:

• Ankylosing spondylitis (AS) and periodontitis (PD) are chronic inflammatory conditions.
• Understanding potential associations between AS and PD is crucial for patient management.

Purpose of the Study:

• To systematically review the existing literature on the association between ankylosing spondylitis and periodontitis.
• To evaluate the prevalence and clinical parameters of periodontitis in AS patients.

Main Methods:

• Systematic literature search conducted in PubMed, Cochrane Library, Scopus, and Web of Science following PRISMA 2020 guidelines.
• Included 18 eligible studies (cohort, case-control, Mendelian randomization) assessed for quality using SIGN and STROBE-MR.
• Keywords focused on spondyloarthritis, ankylosing spondylitis, periodontal diseases, and periodontitis.

Main Results:

• Prevalence of PD in AS patients yielded conflicting results.
• Periodontal parameters (BOP, PPD, CAL) showed correlations with AS parameters, though not always statistically significant.
• PD significantly increased inflammatory markers (IL-6, TNF-α, CRP, ESR) in AS patients; anti-TNF-α therapy impacted periodontal parameters.

Conclusions:

• A definitive conclusion on increased PD prevalence in AS patients remains uncertain due to heterogeneous criteria.
• Correlation between PD and AS parameters, and the effect of AS therapy on periodontal health, are significant findings.
• Screening and treating PD in AS patients may offer clinical benefits, warranting further clinical trials.